Evidence map›Paper›PMID 31598770›Full record

ArticleHNO2020

Upper airway stimulation for obstructive sleep apnea-Can radiological position monitoring predict tongue motion one year after implantation?

A Steffen, A S Wozny, I R König, J-P Goltz, B Wollenberg, K Hasselbacher

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Article in HNO, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

A SteffenDepartment of Otorhinolaryngology, University of Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany. armin.steffen@uksh.de.
A S WoznyDepartment of Otorhinolaryngology, University of Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany.
I R KönigInstitute of Medical Biometry and Statistics, University of Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany.
J-P GoltzInstitute for Radiology, University of Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany.
B WollenbergDepartment of Otorhinolaryngology, University of Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany.
K HasselbacherDepartment of Otorhinolaryngology, University of Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTongue motion patterns (TMP) can influence the outcome of upper airway stimulation (UAS) in the treatment of obstructive sleep apnea (OSA). As a postoperative control, the cuff position of the stimulation lead is monitored via X‑ray imaging. A multidimensional X‑ray assessment system was established and the association between these positional assessments and TMP was investigated 1 year after implantation. MATERIAL AND

methodsThe study on TMP and the X‑ray assessments were carried out at a German ear nose and throat clinic as an implantation center. The TMPs were assessed under bipolar electrode configuration and were categorized according to the currently available literature as right-sided protrusion (RP), left-sided protrusion (LP), bilateral protrusion (BP) and mixed activation (MA). The X‑ray assessment was carried out in five dimensions: the position relative to the mandible and hyoid, cuff steepness in the lateral view of the neck, the cuff position based on the single electrode, and the lead connection to the cuff in the anterior-posterior view. The analyses were performed by three raters with different medical backgrounds and knowledge regarding TMP.

resultsIn approximately 60% of patients, the apnea-hypopnea index was reduced to below 15/h 1 year after implantation. The most common TMPs were RP and BP (82.9%). The interrater variability of the X‑ray assessment was good except for one category. Furthermore, no relevant associations were found apart from the correlation between a favorable TMP and the cuff position with respect to the lateral position of the stimulation cable.

conclusionDespite good interrater variability and convenient usage of the suggested X‑ray assessment system, this approach did not enable the identification of any associations by which a TM and, therefore, a possible straightforward or complicated treatment pathway could be predicted. Attention should possibly be paid to a rotation of the cuff during implantation with a lateral position of the stimulation lead.

Indexed as

Electric Stimulation TherapyRespiratory SystemSleep Apnea, ObstructiveTongueFemaleHumansMaleNosePolysomnographyHypoglossus nerve stimulationInterrater variabilityPAP failureRating systemTongue

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.